Ouch, That Hurts: Childbirth-Related Pain Management and the Inappropriate Replacement of Traditional Obstetrical Knowledge in Kumaon, Uttarakhand, India

Throughout India, obstetrical knowledge and practice has been developed and passed down by generations of women. In many Indian societies, traditional birth attendants, or dais, remain the gatekeepers of childbirth-related knowledge. Yet with the push towards institutional delivery, traditional knowledge and practices are being increasingly replaced with modern and Western ones. While the trend of hospital deliveries has yielded positive health outcomes, its socio-cultural consequences remain unclear. Situated in Uttarakhand’s Kumaon Himalayas, this study employs a bio-social framework and begins to reveal these consequences. Using labor pain management as an entry point, this study argues that the push towards institutional delivery replaces traditional and culturally appropriate obstetric practices with modern and culturally inappropriate ones. This study begins by articulating ideas about childbirth, pain, and pain management that are shared amongst Kumaoni women. It then documents traditional Kumaoni methods of labor pain management and compares them with methods used in area hospitals. Next, it discuses women’s attitudes towards and experiences in government hospitals and suggests novel reasons for which Indian women fear childbirth. The paper then argues that, despite dais having been systematically disenfranchised by the Indian government, the traditional knowledge they possess remains pertinent. Ultimately, the study advocates for the preservation, institutionalization, and awareness of traditional and culturally appropriate methods of labor pain management as a means to promote institutional delivery while also preserving dai culture and allowing women to have healthful and fulfilling childbirth experiences